Wednesday, February 20, 2013

The Pharmacy Years: Palliative Care (Conclusion)

Things were pretty dim in the summer of 2006 as I whiled away the hours in a stressful retail pharmacy in southern Palm Beach county. Days of dread. But then one afternoon a thought appeared out of seemingly nowhere - call the local hospice! It wasn't a completely unsolicited musing. Nearly 2 years before, several months after the first Mom and Pop pharmacy closed, an HR person for the hospice called to verify me as a reference for my old supervisor, the owner of the late store. It was an odd moment. I felt like I wielded a certain power...but of course I gave an honest report - he was one of the sharpest pharmacists I ever worked with.

One of my old coworkers would regularly report to me of how he was doing. A seed in my brain? I figured I'd call.  I still needed to work while in graduate school. I called my one time and future boss and got an interview.  Times had changed. This time he seemed so, I dunno, relaxed during our interview. There was still an urgency and seriousness about him, but far from the authoritarian air I had experienced before. He was very amused with the results of this mini-psych questionnaire I filled out; it confirmed to him I was more of a counselor than a salesperson.  He figured that out not long into my near 8 years with him in retail. Hospice would be a good fit for me.

I laid out my situation and plan; I would be there for less than 1 year until my fourth year audiology externship began. He was fine with that, but nonetheless I did have to go through a lengthy approval process before hire.  I waited and waited. And waited. After 1 month, I got anxious. I was only working part time now at the retail.  VERY part time - Sundays only. I contacted the hospice. Still no answer.  A few days later, I got the call.  I was in.

Palliative care (efforts to alleviate suffering) pharmacy, sometimes defined as something different than hospice care, was a whole new arena for me.  I was told the set-up and operations were similar to those of hospital settings.  Doctors would e-mail/fax orders and techs would process, fill, and deliver oral, topical, and intravenous medications to stations within the facility and to hospitals that had affiliated hospice wings. The main center had around 100 beds. Hospice provides complimentary accommodations and meds for the terminally ill, some of whom are mere days away from passing on.  It was very common to view families weeping in the atrium of the building.  In my 9 months there, that never got easier to witness.

The first month was fairly difficult.  There was a large learning curve and I did not seem to gel with the staff. I found myself eating dinner alone, and often during breaks I wandered the beautiful walkways and gardens in the back of the facility. I felt very isolated.  Being the new guy usually sucks, but it seemed worse than usual.  It had been awhile since I had worked with such a large pool, so many other techs. It may well have been an ego thing - I was used to being "the star", the main guy who did everything.  And...I got unfavorable vibes from one of the guys on staff who was a "star" and didn't seem happy to have me around. I was now one of many and struggling to process a way of pharmacy that was foreign to me.

But within 1 month, I was part of a family. Everything seemed to come together. I began to look forward to going to work. I was a busy bee as I was completing internships during the day and working at night. To maintain 40 hrs. I pulled  two 12 hour shifts a week. It tires me now to think back on those days, but I don't remember complaining or feeling chronically fatigued.  Maybe because I was actually happy in my work.

I worked mainly as a filler and inputter, but also as someone who stocked emergency kits in each nurses' station and dose-filling dispensers in-house and at local hospitals.  I drove to Delray Beach and Palm Beach Gardens a few times a week for this part of my gig.  I loved the independence. Meeting the staff at each hospital was also a perk - Hospice hires some of the most decent humans you'll ever meet. Their reputation is solid in the community. Just ask Matt Lauer, whose father was a patient at Hospice and was so impressed with the organization that he became affiliated with them, even lending his name to their golf tournaments.

Years earlier, I had begun to learn to make IVs and now that knowledge was called upon again. Many orders came in for narcotic analgesic drips. Using this skill, and being required to attain national certification as a tech expanded my pharmacy horizons that much more.   These were things I'd always wanted to do.  Pity that it took so long, just months before my career was done. But it was a fitting send-off to 20 years behind the counter.

The hospice was extremely well run and organized. There was an efficiency that I had not seen in nursing home pharmacy, for certain. Continuing education was encouraged, too. But the best thing about the hospice: my co-workers.  I grew close to my peeps, mainly the night crew. We had a ball! After all the corporate types left for the day. I can't recall laughing so much in my life.  At one point, I found myself with the guys, launching projectiles from the second story of the building. Like kids. Yes, I was in my mid-late 30s, but what a nice alternative to the grim and unpleasant pharmacy atmospheres of the past.  Make no mistake, we were serious about our work and who we were serving, but we also knew how and when to have fun. Those who were strangers in that first month were now pals that several of which I am happy to say are still friends, 6 plus years later.

And my old and present boss? Still extremely precise and managerial, but his personality was far lighter. I guess when you don't have to scrutinize your own business finances to a T it makes a difference in your demeanor. As a retail owner, he was certainly feeling the pinch from the chains and an overall decline in business. He was always hard nosed in those days, but now he was far more pleasant to work with, though given the palliative work model, I was not by his side every minute as before.  The talons were not sinking into my shoulder this time.

Was there drama among the staff? But of course. Law of averages. But none worth recounting, nothing that soured my experience.  I think I've forgotten most of it. My memories of Hospice are quite fond. Until my current job, it was the best I'd had.  Years of pharmacy misery were wiped away. If I'd been in this environment sooner, I may have actually gone on to become a pharmacist. But it all worked out the way it was supposed to.

Even though I was only at the hospice for a fairly short while, I was given a great going away party at a downtown restaurant. Good turnout, and it was fun being silly with the gang one last time (for awhile). The horrendous hangover I had the next morning (made worse as I had to get up very early to transport friends to the airport) was entirely worth it. I went back to visit my co-workers a few times within the next year. Also, I attended a few of their parties and a few "Bunco" nights. A really special group of folks. I'm way overdue to stop in to say hello. They are in a new, larger facility, I've heard.

So thus ends my pharmacy odyssey. I started as an 18-year old ringing a register and concluded as a 38 year old about to begin a career as an audiologist. I've shared a fraction of the highlights along the way and left out much as my rehashing would do little good, but I think these entries are a fair summary.....

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